Health Care Policy Analysis and Critique in Australia - Term Paper Example

Policy Analysis and Critique Name: Institution: Policy Analysis and Critique The Australian government has created numerous healthcare policies aimed at improving the wellbeing of the public. Health care policy refers to the networks of interrelated decisions combined to form a strategy for addressing practical issues in the delivery of healthcare services. Healthcare policies in many cases are formulated from current and past decisions concerning a healthcare issue that requires capstone effort by the government, community, and the health providers (Roussel, 2011). Decisions leading to the formulation of a healthcare policy include revolve much around healthcare service and decisions about the broader social aspect. Policies are made at both the government level and the organization level where most organizational level policies are established to strengthen implementation of certain government policies. The process of policymaking forms a rational decision making steps including political bargaining, understanding of interest group preferences and potential influence, and different ideologies. Policymaking can be viewed as an ongoing process in which decisions made can be changed or modified to accommodate issues arising in the process of the policy implementation. The process is influenced by numerous external factors including demographic, economic, cultural, environmental, legal, and biological among other factors. One the important health care policy in Australia includes the National Mental Health Policy formulated to address the deteriorating mental conditions among citizens. The policy results from the commitment by the Commonwealth states to that Australia is a member to set up strategies of dealing with increased concern in the provision of health services to the mentally challenged (Commonwealth of Australia (CA), 2009). The health policy outlines the new ways that should be adopted by the Australian healthcare system anchors the provision of mental health services. This policy has emerged crucial where studies show that one out of every five Australians face a certain mental health problem. The nationalized policy for mentally ill in Australia was selected for this critical analysis because its implementation has had significant impact on the community, which entails involvement of both primary healthcare providers and the community at large. This paper focuses on the national mental health policy in Australia to demonstrate the process of health care policy formulation. Overview of the National Mental Health Policy The nationalized policy for mentally ill in Australia comprise of strategies for prevention, treatment, advocacy, promotion and rehabilitation. The policy was founded on past mental health plans and the statement of rights and responsibilities. The law aims at promoting mental health of the Australian community, prevention of mental health problem development, and assures the rights of people with mental disorders. Moreover, the law reduces the impact of this health problem on the affected individuals, families, and the entire community (CA, 2009). The policy covers important areas such as mainstreaming of the Australian mental health services, mental health workforce, promotion and prevention, legislation, service mix, research and evaluation of mental services and monitoring mental health agencies. The policy was designed to be implemented within 5years time span through the national mental health strategy, and the least phased marked between 2003- 2008. Implementation of the policy culminated with the 2003-2008 phase that focused on mental health promotion and prevention of the illness, strengthening of quality in the mental health services, enhancement of service responsiveness and emphasis on research in the field of mental health (Council of Australian Governments, 2011). This phase of implementing the policy also focused on promoting innovation, sustainability, and partner with relevant entities such as the educational facilities, employment, and housing sector to promote mental wellbeing among the Australians. The policy implementation further re-emphasizes the need for a collaborative response from the government and the community in addressing the problem of mental illness in the country. Owing to the challenges faced in the institutional treatment of mental illness, the policy was particularly developed to establish ways of circumventing such challenges. In order to promote mental wellbeing among the Australians, it was considered necessary to abandon the focus on maintaining segregated areas such as the psychiatric hospital and instead adopted a significantly balanced hospital based and community based care for the mentally ill people (McAuley & Menadue, 2007). Construction of the policy revolved around provision of solutions to problems experienced in the previous years in caring for people with mental health problems. The policy sought to strike a balance between inpatient psychiatric care and community care for victims of mental illness in order to promote improved outcomes among the patients. Formulation of the policy also sought to ensure that the needs of people with mental illnesses including employment, housing, income support and community support are guaranteed. The policy was formulated to provide the new approach in the treatment of people with mental problems in order to avert previous challenges experienced by healthcare institutions and community at large (CA, 2009). The policy was also adopted as part of the decisions aimed at introducing and facilitating reforms in the mental health interventions to boost their outcomes. The national mental health law was also seen as a way of ensuring legislation of the United Nations (UN) resolutions on the rights of the mentally challenged in all the territories. Social Impacts of the Policy The policy was formulated to deal with issues that had contributed to the increased mental health problems in the Australian community despite existence of psychiatric hospitals established to handle the health issue. Construction of this policy was particularly catalyzed by the UN resolution on the protection of rights of mentally ill people in its member states (World Health Organization, 2005). The Commonwealth governments realized the vulnerability of people with mental problems to abuse and violation of their individual rights, thereby expressing the need for all member countries to establish strategies to guarantee their rights protection. The Australian mental health policy has facilitated the shift from the segregated form of caring for people with mental health to a sustainable integration of the community care and the hospital care. The shift has had significant impacts on the community including increased awareness on the issue of mental health. Owing to the focus on community healthcare in handling mental illnesses, Australians have achieved better understanding of the problem as well as ways of dealing with such incidents in the community. The policy has also seen increased accessibility to the healthcare services helping to reduce the number of severe cases as well as reduction of mental illness among the Australians. Individuals with mental problems have been provided with the opportunity to continue interacting and building of the community. The need to incorporate people with mental illnesses has allowed them lead a relatively normal life rather segregating. This has formed part of the decisions that culminated in the construction of the health policy for mentally affected in Australia (CA, 2009). The policy has played a critical role in reducing the stigma associated with mental illness, which greatly undermines the willingness of the people with such conditions and their families to seek health care intervention. In this case, implementation of the policy has seen the number of people with mental disorders and their families seek mental healthcare services. In addition, the community has also shown positive attitude and commitment in caring for people with mental disorders rather than alienating them from the rest of the community. Such impacts on the community and the affected individuals particularly played an important role in the move towards creating a mentally healthy Australian community. Involvement of the community in caring for the people with mental disorders has contributed to the better mental health care intervention outcomes among the Australians. Health Care Principles Underlying the National Mental Health Policy The principles of universal and equality in the accessibility of primary health that all Commonwealth states are signatories underlined the construction of the Australian National policy for mentally ill (Sherbon, 2010). The principle compelled the Australian government to formulate strategies capable of ensuring that its healthcare systems abide by it. These principles demanded significant involvement of the government in the healthcare system to guarantee achievement of the universal accessibility and equity principle. The government involvement could include injection of financial aid and regulation of healthcare system as well as planning of its operations in order to reach all Australians. The concept of promoting accountability and responsiveness to the needs of all Australians also formed a strong basis for formulation of the policy. Formulation of the policy also sought to eliminate the concept of specialization in the provision of services to the mentally challanged through the emphasis on the need for government, non-governmental, the community and the health system to address the problem of mental illness. Some of the decisions that enhanced the formulation of the policy revolved around ways of involving other service providers such as housing, support for disabled people, welfare, and education institutions among others in the alleviation of mental illness problems in the country’s society. The process of formulating the policy revolved around the belief that just like people with disabilities, people with mental disorders can also lead a fruitful and satisfying life with the necessary support and provision of opportunities. Decisions that birthed this policy targeted the ensuring that people with mental disorders live a normal life and contribute to the development of the community (Sherbon, 2010). The other concept factored in the formulation of the policy revolved around the need to avert the stigmatization challenge faced by people with mental illness. The focus underlined by the concept included the change in the perception about mentally ill people that has seen them being segregated from the community to specialized facilities as well as discrimination. This change was to be achieved through implementation of changes on delivery of mental health services from the specialized institutions to the community-based care. However, the delivery needed significant balance between the community-based care and the specialized treatment since both are equally important in producing favorable outcomes in the interventions. Opportunity Costs, Benefits Cost Effectiveness and Regulatory Impact The process of making the policy had to factor in the benefits of shifting the mental healthcare from the institutionalized system to the community based notwithstanding the negative effects of the approach. Reduction or replacement of the psychiatric hospitals with community based services posed both positive and negative aspects that needed to be weighed out. In this case, community based healthcare purported by the policy had numerous benefits compared to the institutionalized care that often increased the stigma experienced by people with mental illness (CA, 2009). The community care for mental illness reduces the costs incurred by families and individuals with mental illness in seeking intervention in the specialized hospitals. The shift from institutionalized care to the community-based system enhances accessibility of mental health services to all people including the low income families. In terms of costs of treatment, the new policy seeks to make affordable for both the community and the federal government. Community based mental health service model takes the services closer to the consumer, increasing its accessibility and affordability as opposed to the specialized model of mental health intervention. Nevertheless, the shift from institutionalized mental health intervention faces significant threats in the maintenance of quality of the services provided especially for severely affected individuals. Implementation of this policy ushers in substantial strains on the government budget in which it must ensure that the community-based services are evenly distributed and unbiased. The Australian national mental health policy poses greater economic costs associated with the provision of the community based care. For example, the government and health insurers’ provisions for mental illness accounted by approximately 7.3 percent of the total government spending on healthcare (Council of Australian Governments, 2011). The policy demands that the government funds a wide range of community services for the mentally challenged group through domiciliary care, shelter, training, and creation of employment opportunity. The policy requirements therefore pose a great challenge to the government in terms of increased costs of providing the community based mental healthcare services. The community-based care supported by the mental health policy requires increased number of qualified mental health professionals thereby increasing the cost of providing the services. Studies indicate that the number of healthcare professionals participating in the community care increased by about 51% in the period between 1993 and 2007 (Council of Australian Governments, 2011). By 2007, the total expenditures associated with community care had increased by 29 percent, and the expenditures were likely to continue escalating due to the emphasis on quality and even distribution of the services. Although, the mental healthcare services are high, the economic costs associated with mental illness are higher hence the need to implement the policy. Diversity and Social Inclusion in Policymaking The policy makers recognized that the Australian community is diverse and the community care services required inclusive efforts in order to be successful. The Australian community is characterized by cultural and religious differences that needed significant considerations during formulation of the policy to ensure that none of the groups was discriminated from the community effort. Although the cultural and religious differences present some strengths and opportunities in the community, it was important to recognize the potential challenges associated with such differential parameters. Policy makers needed to show cultural competence in establishing the various strategies included in the policy to enhance responsiveness to mental disorders in the community (Australian Commonwealth, 2006). The policy makers recognized some of the challenges faced by women suffering from the mental disorders including sexual abuse and trauma exposed to the female gender with the disorder in their early childhood. These issues needed to be brought to the attention of the healthcare providers and employers working with people with mental disorders in their workforces. The policy makers wanted to make safe and secure environment for people with mental disorders to facilitate their healing and inclusion in the society. Consideration of the rural and indigenous communities was important if the equitable and universal principle were anything to go by in the formulation of the policy (Australian Commonwealth, 2006). In this case, it was important to investigate the diverse needs of the local communities and reflect them in the formulation of the policy. All changes associated with the policy needed to reflect the interests of the diverse Australian society in order to facilitate acceptability and cooperation in the implementation of the policy. The policymakers focused on promotion of equity across the diverse communities, cultures, individuals, age groups and regions of the country. The policy further promises environmental sustainability through equitable resource distribution even that covers the mentally challenged citizens. The policy provisions assure that damages affecting people with mental disorders are minimized thereby preserving the habitats. Management of natural resources is also likely to receive a positive impact as the community moves towards involvement of people with mental disorders in the development of the community (Council of Australian Governments, 2011). The policy needed to establish mechanisms of ensuring equity and fair accessibility of quality and highly responsive mental health services regardless of the cultural orientation, age, location, and gender (Willis, Reynolds & Helen, 2008). The social inclusiveness in the policy revolved around all tangible parameters underlying an active community in the effort to give healthcare to Australians that are mentally deprived. The policy makers aimed at establishing integral approaches in the treatment of mental disorders involving justice, housing, health systems, community, and the employment sectors. The justice sector involving the police, the courts, correctional and rehabilitation centers had a great role in addressing issues affecting people with the mental problems. It was particularly important to include the law enforcement bodies in the all-inclusive policy in order to guarantee protection of the rights of people with the mental problems. Accountability in the Provision of Care to Mentally Ill The national care policy also covered strategies to promote accountability in the provision of the community mental health services. The policy makers established ways of ensuring that consumers and caregivers get access to information about the performance of the healthcare institutions and their responsiveness in addressing the mental health issues among the Australians (Trauer, 2010). The policy provided mechanisms for evaluating the activities of the Australian healthcare system with significant focus on the issues of mental health that is increasingly becoming a great concern in the Australian community. The policy established national benchmarks to control the quality of health care services provided through the community-based health care approach. The policy demanded for regular reports on the reforms associated with the policy implementation to ascertain the progress and accountability in accountability in both the community and the specialized mental service institutions. The focus on accountability in the policy making process aimed at ensuring that resources allocated to the community mental health programs are put into proper use. The shift to the community care from the institutionalized system needed effective accountability mechanisms ensure that efforts by the government to promote equity and universal accessibility to quality mental health care are not in vain. Legal and Political Issues The policy provisions involved issues of legislation particularly the outlining of rights to guard the mentally sick, and establishing mechanisms to ensure such rights are well guarded. This was in recognition of the vulnerability of the mentally challanged to individual’s rights abuse by the rest of the society. The policy required the legislation of rights for people with mental disorders in all areas of the country as well as amendment of certain legal clauses to accommodate protection of the mentally ill people within the Australian community (Australian Commonwealth, 2009). The policy proposed strategic reforms in the legislations to ensure that mentally challenged citizens are treated equally, and provided with equal opportunities in all other sectors outside the healthcare system. A proper legal map was necessary to guide the community on how it ought to treat people with mental disorders as way of their proper integration in the community. Politically, the policy was constructed as a response to the UN resolution on the rights and treatment of people with mental disorders among the Commonwealth governments and territories (World Health Organization, 2005). Australia as a member needed to establish a policy capable of meeting such requirements through initiation of changes in its healthcare systems. The establishment of the national mental health policy involved consultation of political advisors for informed accounts of the need to abide by the UN resolutions and the Commonwealth agreements on promoting mental health in the member states. The policy requires streamlining of the Australian mental health legislations to conform to the UN resolution on protection of rights of people with mental disorders. The policy sought to drive conformity in all legislations across all sectors in Australia to guarantee fair treatment of people with severe and mild mental disorders. In this context, all crucial stakeholders were involved in the policy making to ensure that all inclusive views and ideas were taken into consideration to guarantee successful implementation. The media fraternity on the other hand played an important role in educating the public on the policy contents through coverage in community, school, and media based activities (Trauer, 2010). Additionally, implementation of the mental health policy bears potentially significant influence on the electoral sector as people gain confidence on the leadership, and enables people with mental health disorders to participate in elections. Recommendations and Conclusion The policy construction process needed to take into consideration the views of the community on the issue of shifting mental healthcare from the institutionalized approach to the community-based approach. This step would be critical in determining the reaction of the community toward the approach and determination of its feasibility. Another consideration that needed consideration during formulation of the policy includes participation of the community in the entire process to ensure that all their demands are harmonized and reflected in the policy document. Community participation would guarantee positive reception of the policy requirements and successful implementation. The policy makers also needed to strike a proper balance between specialized treatment and the community based approach. This would not only guarantee quality treatment of the people with mental disorders but also reduce the cost of shifting the care to the community level. Exclusive community care would result in increased cost of providing the services as the government must strive to ensure equity and universal accessibility of the services to all people in all areas. In conclusion, the Australian government should remain commitment to the National Mental Health Policy because it provides the potential way of promoting mental health in the Australian community. The completed implementation phases have translated to significant benefits to not only the people with mental disorders but also the community and the government economically. The policy making process took into account most of the requirements for construction of effective policies including legal, political issues, community impact, and the entire Australian community. The policy aims at promoting proper treatment of people with mental disorders in the Australian community regardless of the location, social status and gender. The policy has initiated strategies to promote collaboration of the health sector with like the community in enhancing the mental health of Australia. References Australian Commonwealth. (2006). Cultural competency in health: A guide for policy, partnerships and participation. Australian Commonwealth. Retrieved from http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/hp19.pdf?q=publication s/synopses/_files/hp19.pdf Commonwealth of Australia. (2009). Fourth national mental health plan: An agenda for collaborative government action in mental health 2009-2014. Commonwealth of Australia. Retrieved from http://www.health.gov.au/internet/main/publishing.nsf/content/360EB322114EC906CA2 576700014A817/$File/plan09v2.pdf Commonwealth of Australia. (2009). National mental health policy. Commonwealth of Australia. Retrieved from http://www.health.gov.au/internet/main/publishing.nsf/content/BF4CF02AE1033BF1CA 25722200119A23/$File/policy.pdf Council of Australian Governments. (2011). 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